On the 31st October and 1st November, MS researchers, MS nurses, clinicians and allied health providers gathered in Melbourne to discuss their latest work and most exciting findings.
This was our seventh Progress in MS Research Conference which was held over two very full days. There were close to 50 oral presentations and over 70 poster presentations making this one of the largest scientific programmes we have ever had.
The conference is designed to help boost collaboration and stimulate innovative research into the causes, prevention, improved treatments and ultimately cures for MS. These are ambitious goals and to achieve this we need to collaborate and work together – as the saying goes “alone we can do so little; together we can do so much”. The delegates at the conference truly embraced this notion and there was a high level of exchange of scientific thought and investigation among neurologists, scientists, biologists and health researchers.
In addition to the 150+ Australian scientists, we had three fantastic international experts from the US and Sweden who shared their research and built relationships with our researchers here in Australia.
The main themes of the conference were:
However, many other fascinating and important results were shared across diverse fields including diet and causes of MS, autologous heamatopoetic stem cell therapy (AHSCT), immunology, physiotherapy and more.
Smarter Clinical Trials
All MS treatments need to go through clinical trials to prove that they are safe and effective. Traditionally, clinical trials in MS have used the number of relapses a person has as a sign of whether the treatment being trialled has been successful or not. However, as our treatment options get better and the number of relapses are being reduced, we need additional indicators to show whether a treatment option is superior to current treatments.
We also need robust indicators for disease progression in people with progressive MS, as one challenge hampering the development of new medications is the lack of a readily available robust and objective measures of disease progression. A number of different researchers are busy trying to develop such measures and presented their progress at the Conference.
Dr Eduardo Cofre Lizama from the University of Melbourne explained his latest discovery – that certain ankle muscles activate in order to compensate for various changes in gait due to MS – which could potentially be used as a measure of disease activity.
Daniel Merlo from Monash University presented his work involving the use of online tools to determine changes in cognition, with these changes then being used to predict the trajectories of a person’s MS.
Up-and-coming researcher Kira Groen from the Hunter Medical Research Institute at The University of Newcastle shared data looking at a type of genetic material in the blood, known as RNA, and showed how it changed at different times in the MS disease course.
The work of these researchers is diverse, tackling the challenge from very different angles. However, all of these approaches could help us come up with a range of new measures to track and predict the direction of someone’s MS, as well as monitor how they are responding to existing medication or novel therapies.
Deep Characterisation of MS
Advances in technology are providing amazing new tools allowing scientists to see further and further into MS.
Exciting research presented from an early career researcher, Dr Felix Marsh-Wakefield from the University of Sydney, showed analysis of blood from people with and without MS. He looked at up to 37 proteins on the surface of cells simultaneously, providing an even deeper understanding of what is happening to a type of immune cell called ‘B cells’ in people with MS.
Dr Scott Kolbe from the University of Melbourne explained his work using cutting edge magnetic resonance imaging (MRI) technologies to measure the density of nerve fibres in the brains of people with MS. He has discovered that this measurement is nearly seven times more sensitive than measuring changes in brain volume, and is a good indicator of changes in a person’s cognition such as thinking and memory.
Technology also enables very detailed analysis of the genetic composition of individual cells – something which was previously unobtainable.
Associate Professor Justin Rubio outlined his research investigating changes in DNA of single brain cells affected by MS. This study fitted nicely with the work of one of the international speakers, Associate Professor Gonçalo Castelo-Branco, who is also using some of the latest genetic technologies to decipher which genes are activated in individual brain cells. He showed that some of the cells which coat nerve fibres in myelin, may also have a function within the immune system. These cells make up a small portion of myelin producing cells and without our ability to look at cells individually they would have remained hidden. Now they have been uncovered, this raises the next question – what role might these cells play? The answer may revolutionise the way we think MS develops.
Patient Reported Outcomes
Technology and wearables (e.g. fitness trackers and smart devices) were also mentioned in research looking at patient reported outcomes. Scientists are finding new ways to systematically collect patient reported outcomes – a vital area of research considering that the person living with MS is the one with the most insight into their own journey with the disease.
We heard from Associate Professor Ingrid van der Mei from the Menzies Institute for Medical Research, about her plans in conjunction with MS Research Australia to build a platform to combine clinical data with patient reported outcomes, as well as other data. The aim of this is to help develop a fully integrated picture of a person’s MS, known technically as ‘deep phenotyping’, to improve treatment decisions.
To collaborate with and leverage off other areas of health, Professor Chris Bain from Monash University presented what is happening in the digital health sector, which aligned well with what people are investigating in the MS research arena.
Dr Jo Lane from the Australian National University presented her work, which includes collaboration between a range of scientists, health care providers and people living with MS to develop integrated genetic and digital medical technologies for disease monitoring.
All of these projects share the goal of developing an integrated system for people with MS to be well informed and empowered to actively manage their health and wellbeing.
Accelerating the Drug Development Pipeline
Another important area was translating fundamental biological research (the first stage in the research process) out of the laboratory into the clinic faster.
Dr James Hilton presented his research looking at a drug which helps redistribute copper in the brain and spinal cord which is potentially contributing to the death of nerve cells, not just in MS but also motor neuron disease (MND).
Additionally, Dr Steven Petratos from Monash University showed promising results of a treatment option which involved using stem cells as a drug delivery tool. His work showed that these cells can migrate to the brain where they can then help with the repair of myelin in laboratory models.
These were only two of the novel therapies described at the conference, but it is vital that these treatments are rapidly translated to the clinic. The pathway from the lab to the clinic is a long and arduous path, and one of the sessions at the conference specifically tried to address this. A panel discussion included contributors with experience in taking fundamental research into clinical development. In Australia, there is a depth of talent to make this happen but at the moment the process can be fragmented and this session aimed to bring people together to accelerate important fundamental research into the clinic.
Onwards and Upwards
Overall it was amazing to see such dedication, commitment and quality of the scientists in the room. Additionally, there were a number of young up-and-coming scientists presenting their work which was world-class – a clear indication that MS research in Australia is only going to go from strength to strength.